난소의 경계성 및 악성 표면상피종양에서 c-erbB-2, EGFR, p53 발현 및 Ki-67 지수에 관한 연구
The Expression of c-erbB-2, EGFR, p53 and Ki-67 in Ovarian Borderline Tumors and Carcinomas of the Ovary
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난소암종 환자에서 병리학적 소견은 환자의 진단과생존율 예측 인자를 찾는 데 활용될 가능성이 있고, 특히 p53과Ki-67은 분화도가 나쁜 난소암종에서 과발현하여 후에 환자의예후를 예측하는 표지로 활용될 가능성이 있다. 본 연구에서는c-erbB-2와 EGFR 발현 여부에 따라 환자의 생존율에 통계적으로 유의한 차이가 나타나지는 않았다. 그러나 난소암종에서c-erbB-2와 EGFR에 대한 면역조직화학적 검사를 통해 성장인자에 대한 항체를 이용한 면역치료가 가능한 환자군을 구분하는데 이용 가능한 방법으로 생각한다. 그러나 향후 더 많은 상피성 난소종양 환자를 대상으로 하여 c-erbB-2, EGFR, p53의발현에 대한 분자생물학적 및 면역조직화학 연구와 ki-67 지수등에 대한 전향적인 연구를 시행하여, 난소암종 환자의 예후를예측하는 인자로 활용이 가능성을 알아보아야 하겠고, 이결과를토대로 하여 새로운 표적치료가 가능한 환자군을 선택하는데 이런 표지자들이 사용가능할 것인지에 대한 추가적인 연구가 필요하다고 생각한다.
Abstract
Background : An ovarian surface epithelial tumor is a heterogenous disease, and various biological and molecular factors are important for its development and progression. Several findings support EGFR or c-erbB-2 as adverse prognostic indicators for an ovarian carcinoma. Methods : We reviewed the histological and clinical findings of 52 carcinomas (17 endometrioid, 16 serous, 13 mucinous and 6 clear cell tumors), and 26 borderline (10 serous and 16 mucinous) tumors. Expression of c-erbB-2, EGFR, p53, and Ki-67 was evaluated on paraffinembedded tissue from a primary ovarian tumor by immunohistochemical methods. Results : Expression of c-erbB-2 was found in 7.6% of tumors and expression of EGFR was found in 9.6% of tumors by immunohistochemical analysis. No significance was found between cerbB- 2 and EGFR expression as indicators of a poor prognosis. The expression of p53 and Ki-67 (>50%) correlated with the grade and type of tumor in the ovarian cancers. p53 and Ki- 67 overexpression (>50%) was absent in the borderline ovarian tumors, whereas ovarian carcinomas showed expression of both p53 and Ki-67. Conclusion : Expression of c-erbB- 2, EGFR, p53, and Ki-67 as determined by immunohistochemical analysis did not correlate with prognostic significance. However, p53 and Ki-67 expression may be used as markers to predict aggressive behavior, and to differentiate between malignant and borderline epithelial ovarian tumors. Further large-scale studies are required to clarify the significance of c-erbB-2 and EGFR expression in ovarian tumors.
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